Assessment of maternal serum β hCG level in pregnancy induced hypertension and normotensive patients and to correlate between the level of β hCG with the severity of pre-eclampsia and eclampsia

Background: Hypertensive disorders during pregnancy are one of the most common medical complication seen during pregnancy, affecting around 5-10% of all pregnancies. Spectrum of this disease ranges from mildly elevated blood pressure with minimal clinical significance to severe hypertension with multi organ dysfunction. Pre-eclampsia complicates about 2-8% of all pregnancies. Pre-eclampsia incidence in India is about 8-10%. Various studies have depicted that, there is a strict relationship between PIH and elevated serum β-hCG level.Methods: This one-year prospective case control study toteled 200 pregnant women attending antenatal care and admitted in eclampsia ward fulfiling the inclusion criteria were studied. Serum βhCG levels were estimated by chemiluminescent microparticle immunoassay. Statistical analysis of data was done by student’s t-test and p-value.Results: The mean β hCG level in PIH patients was found to 36851.59 mIU/ml with standard deviation of 22916.58 while the mean β hCG in normotensive patient was 15433.26 mIU/ml with standard deviation of 6861.56. (p <0.001). The mean β hCG level in gestational hypertensive patients was 25206.19 mIU/ml with a standard deviation of 8696.9. The mean β hCG level in pre-eclamptic patients was 61697.67 mIU/ml with standard deviation of 18498.57. The mean β hCG level were 84106.38 mIU/ml with standard deviation of 11295.05 in the eclamptic patient. The above values were statistically significant (p <0.001).Conclusions: We concluded that there was a striking relation between the PIH including pre-eclampsia and eclampsia with the elevated serum βhCG level. Concluding that early detection of altered serum βhCG shell aid in better management of pre-eclampsia and eclampsia cases which would play a pivotal role in improving the maternal and fetal outcome.

Posterior Reversible Encephalopathy Syndrome: A Case of Hypercalcemia

Posterior reversible encephalopathy syndrome is an encephalopathy that can be clinically characterized by headache, altered mental status and/or seizures. Neuroimaging demonstrates usually reversible bilateral subcortical vasogenic occipital-parietal edema. Exact pathophysiology remains unclear but is commonly associated with hypertension, renal failure, sepsis and use of immunosuppressive therapy. Its development in the setting of severe hypercalcemia is extremely rare. The authors report a case of posterior reversible encephalopathy syndrome in a normotensive patient with severe hypercalcemia as the only identifiable cause.

In the Pre-eclamp sia and Normotensive Patient- Lipid Profile Study

Pre-eclampsia is associated with substantial risks for the fetus and mother. Disorders of lipoprotein metabolism are reported to be a major cause of hypertension and proteinuria in pre-eclampsia. This was a cross-sectional comparative study carried out in the Department of Obstetrics and Gynecology, Sylhet, M.A.G Osmani Medical College Hospital, Sylhet during December 2013 to May 2014. 50 pre-eclampsia and 50 normotensive pregnant women's serum lipid profile were selected according to inclusion and exclusion criteria. Fasting lipid profile was measured after 10-12 hours overnight fasting. The mean age (25.12 # 3.98 years vs 24.94 # 3.90 years; p=0.820), gestational age (36.80 # 0.70 weeks vs 36.9 # 1.1 weeks ; p=0.144), and BMI (21.43 # 2.09kg/M2 vs 22.02 # 1.73kg/M2, p=0.131) were statistically similar in both pre-eclamptic women and the control pregnant women. SBP (163.70 #11.24mm of Hg vs 115.10 # 9.39mm of Hg; p<0.001) and DBP (103.6 #9.4mm of Hg vs 71.50 #5.37mm of Hg p<0.001) were significantly higher in pre-eclamptic women than that of normotensive pregnant women. Serum total cholesterol (227.56 # 55.79mg/dl vs 194.56 # 43.33mg/dl, p=0.001). serum LDL-cholesterol (147.72 #51.03mg/dl vs 119.43 # 37.17mg/dl; p=0.002) and serum triglyceride (232.06 # 65.54mg/dl vs 157.44 # 64.24mg/dl p<0.001) were significantly higher in pre- eclampsia than that of normal pregnancy; while serum HDL- cholesterol (38.96 # 2.93 mg/dl vs 45.82 # 6.11 mg/dl; p <0.001) was significantly lower in pre-eclampsia than that of control pregnancy. An abnormal lipid profile has a direct effect on endothelial dysfunction. Early detection of these parameters may help patient by preventing complications in pre-eclampsia.Medicine Today 2017 Vol.29(2): 1-4